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Marino RA, Gaprielian P, Levy R. Systemic D1-R and D2-R antagonists in Non-Human Primates Differentially Impact Learning and Memory While Impairing Motivation and Motor Performance. Eur J Neurosci 2022; 56:4121-4140. [PMID: 35746869 DOI: 10.1111/ejn.15743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
Dopamine (DA) modulates cognition in part via differential activation of D1 and D2 receptors within the striatum and prefrontal cortex, yet evidence for cognitive impairments stemming from DA blockade or deficiency is inconsistent. Given the predominance of D1 over D2 receptors (R) in the prefrontal cortex of primates, D1-R blockade should more strongly influence frontal executive function (including working memory), while D2-R blockade should impair processes more strongly associated with the dorsal striatum (including cognitive flexibility, and learning). To test how systemic DA blockade disrupts cognition, we administered D1-R and D2-R like antagonists to healthy monkeys while they performed a series of cognitive tasks. Two selective DA receptor antagonist drugs (SCH-23390 hydrochloride: D1/D5-R antagonist; or Eticlopride hydrochloride: D2/D3-R antagonist) or placebo (0.9% saline) were systemically administered. Four tasks were used: (1) 'visually guided reaching', to test response time and accuracy, (2) 'reversal learning', to test association learning and attention, (3) 'self-ordered sequential search' to test spatial working memory, and (4) 'delayed match to sample' to test object working memory. Increased reach response times and decreased motivation to work for liquid reward was observed with both the D1/D5-R and D2/D3-R antagonists at the maximum dosages that still enabled task performance. The D2/D3-R antagonist impaired performance in the reversal learning task, while object and spatial working memory performance was not consistently affected in the tested tasks for either drug. These results are consistent with the theory that systemic D2/D3-R antagonists preferentially influence striatum processes (cognitive flexibility) while systemic D1/D5-R administration is less detrimental to frontal executive function.
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Affiliation(s)
- Robert A Marino
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Department of Surgery, Kingston General Hospital, Kingston, Ontario, Canada
| | - Pauline Gaprielian
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Ron Levy
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Department of Surgery, Kingston General Hospital, Kingston, Ontario, Canada
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Gaprielian P, Scott SH, Lowrey C, Reid S, Pari G, Levy R. Integrated robotics platform with haptic control differentiates subjects with Parkinson's disease from controls and quantifies the motor effects of levodopa. J Neuroeng Rehabil 2019; 16:124. [PMID: 31655612 PMCID: PMC6815040 DOI: 10.1186/s12984-019-0598-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/20/2019] [Indexed: 02/01/2023] Open
Abstract
Background The use of integrated robotic technology to quantify the spectrum of motor symptoms of Parkinson’s Disease (PD) has the potential to facilitate objective assessment that is independent of clinical ratings. The purpose of this study is to use the KINARM exoskeleton robot to (1) differentiate subjects with PD from controls and (2) quantify the motor effects of dopamine replacement therapies (DRTs). Methods Twenty-six subjects (Hoehn and Yahr mean 2.2; disease duration 0.5 to 15 years) were evaluated OFF (after > 12 h of their last dose) and ON their DRTs with the Unified Parkinson’s Disease Rating Scale (UPDRS) and the KINARM exoskeleton robot. Bilateral upper extremity bradykinesia, rigidity, and postural stability were quantified using a repetitive movement task to hit moving targets, a passive stretch task, and a torque unloading task, respectively. Performance was compared against healthy age-matched controls. Results Mean hand speed was 41% slower and 25% fewer targets were hit in subjects with PD OFF medication than in controls. Receiver operating characteristic (ROC) area for hand speed was 0.94. The torque required to stop elbow movement during the passive stretch task was 34% lower in PD subjects versus controls and resulted in an ROC area of 0.91. The torque unloading task showed a maximum displacement that was 29% shorter than controls and had an ROC area of 0.71. Laterality indices for speed and end total torque were correlated to the most affected side. Hand speed laterality index had an ROC area of 0.80 against healthy controls. DRT administration resulted in a significant reduction in a cumulative score of parameter Z-scores (a measure of global performance compared to healthy controls) in subjects with clinically effective levodopa doses. The cumulative score was also correlated to UPDRS scores for the effect of DRT. Conclusions Robotic assessment is able to objectively quantify parkinsonian symptoms of bradykinesia, rigidity and postural stability similar to the UPDRS. This integrated testing platform has the potential to aid clinicians in the management of PD and help assess the effects of novel therapies.
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Affiliation(s)
- Pauline Gaprielian
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada.,Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, K7L 3N6, Canada.,Department of Medicine, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada
| | - Catherine Lowrey
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Stuart Reid
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada.,Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Giovanna Pari
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada.,Department of Medicine, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada
| | - Ron Levy
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada. .,Department of Surgery, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada.
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Dunlop K, Gaprielian P, Blumberger D, Daskalakis ZJ, Kennedy SH, Giacobbe P, Downar J. MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder. J Vis Exp 2015:e53129. [PMID: 26327307 PMCID: PMC4692428 DOI: 10.3791/53129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Here we outline the protocol for magnetic resonance imaging (MRI) guided repetitive transcranial magnetic stimulation (rTMS) to the dorsal medial prefrontal cortex (dmPFC) in patients with major depressive disorder (MDD). Technicians used a neuronavigation system to process patient MRIs to generate a 3-dimensional head model. The head model was subsequently used to identify patient-specific stimulatory targets. The dmPFC was stimulated daily for 20 sessions. Stimulation intensity was titrated to address scalp pain associated with rTMS. Weekly assessments were conducted on the patients using the Hamilton Rating Scale for Depression (HamD17) and Beck Depression Index II (BDI-II). Treatment-resistant MDD patients achieved significant improvements on both HAMD and BDI-II. Of note, angled, double-cone coil rTMS at 120% resting motor threshold allows for optimal stimulation of deeper midline prefrontal regions, which results in a possible therapeutic application for MDD. One major limitation of the rTMS field is the heterogeneity of treatment parameters across studies, including duty cycle, number of pulses per session and intensity. Further work should be done to clarify the effect of stimulation parameters on outcome. Future dmPFC-rTMS work should include sham-controlled studies to confirm its clinical efficacy in MDD.
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Affiliation(s)
| | | | - Daniel Blumberger
- Department of Psychiatry, University of Toronto; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health
| | - Zafiris J Daskalakis
- Department of Psychiatry, University of Toronto; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health
| | - Sidney H Kennedy
- MRI-Guided rTMS Clinic, University Health Network; Department of Psychiatry, University Health Network; Department of Psychiatry, University of Toronto
| | - Peter Giacobbe
- MRI-Guided rTMS Clinic, University Health Network; Department of Psychiatry, University Health Network; Department of Psychiatry, University of Toronto
| | - Jonathan Downar
- MRI-Guided rTMS Clinic, University Health Network; Department of Psychiatry, University Health Network; Toronto Western Research Institute, University Health Network; Department of Psychiatry, University of Toronto;
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